PT  - JOURNAL ARTICLE
AU  - Walter P. Maksymowych
AU  - Meaghan Pitts
AU  - Matthew J. Budak
AU  - David Gracey
AU  - Robert G. Lambert
AU  - David McDougall
AU  - Marcus Pianta
AU  - Winston J. Rennie
AU  - Stephanie Wichuk
AU  - Naomi Winn
AU  - Jacob L. Jaremko
TI  - Development and Preliminary Validation of a Digital Overlay-based Learning Module for Semiquantitative Evaluation of Magnetic Resonance Imaging Lesions in Osteoarthritis of the Hip
AID  - 10.3899/jrheum.141574
DP  - 2016 Jan 01
TA  - The Journal of Rheumatology
PG  - 232--238
VI  - 43
IP  - 1
4099  - http://www.jrheum.org/content/43/1/232.short
4100  - http://www.jrheum.org/content/43/1/232.full
SO  - J Rheumatol2016 Jan 01; 43
AB  - Objective. To develop and validate a knowledge transfer (KT) module aimed at enhancing feasibility and reliability of semiquantitative assessment of bone marrow lesions (BML) and synovitis-effusion using the Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS).Methods. Three radiologists naive to the HIMRISS method reviewed the manuscript describing the method and then scored MRI scans from 16 patients with hip OA obtained at baseline and 8 weeks after intraarticular injection of corticosteroid. Readers then reviewed a KT module comprising an instructional presentation and 8 reference DICOM (digital imaging and communications in medicine) cases scored by 3 readers with expertise in the HIMRISS method, and then used electronic overlay software to score scans from 23 patients with OA. The same format was followed with a second group of 3 readers naive to HIMRISS using a KT module revised to incorporate the overlay with a Web-based DICOM viewer to enhance feasibility. Interobserver reliability was assessed with the intraclass correlation coefficient (ICC).Results. In both exercises, reliability for baseline scores was excellent for femoral BML, very good for acetabular BML, and good for synovitis-effusion (overall ICC = 0.91, 0.89, 0.62, respectively) even without prior calibration using the KT module. However, reliability for detecting change was substantially worse than for expert readers, especially for acetabular BML and synovitis-effusion (overall ICC = 0.59 vs 0.19, and 0.42 vs 0.25, respectively). Reliability improved for detection of change in these lesions, especially after reader calibration with the revised KT module.Conclusion. Development and validation of a systematic method for KT may enhance external validation of certain imaging instruments.